EENAL CONGESTION. 723 



carefully examined, tlie minute urine-tubes sliow a loosening 

 and discharge of their epithelial lining. Should this state of 

 congestion be protracted or often repeated, changes of a some- 

 what different nature will develop themselves, chiefly deter- 

 mining the character of the urine-tubes, the amount of inter- 

 tubular connective-tissue and total bulk of the gland. 



Symptoms. — The arrest of the blood in the vessels which 

 surround the uriniferous tubes, and consequent turgescence of 

 the malpighian capillaries, accounts in numerous instances for 

 many of the symptoms of congestion and inflammation parti- 

 cularly attendant on recoveries from certain fevers and other 

 general disturbances. 



With few or no constitutional symptoms the only attractive 

 feature may be an alteration in the urinary secretion ; this, 

 although usually and in all established cases lessened in 

 amount and of greater density, from the presence of an extra 

 amount of solid materials, with, it may be, albumen and blood 

 or blood-colouring matter, is, in a few of the milder develop- 

 ments and at the commencement, of a more watery character 

 and augmented in bulk. With a continuance of the hyper- 

 semia, or its repetition in close succession and consequent 

 textural changes, the character of the secretion may also 

 vary, and certain tube-casts and particular cell-structures 

 be added. 



The milder cases, which do not proceed to inflammatory 

 action, or by repetition to serious changes in the gland, usually, 

 after a few days, decline, and the urine assumes its normal 

 characters. 



Treatment. — When dependent on some general diseased con- 

 dition the management of the renal congestion must not be 

 undertaken apart from that of the state with which it is so 

 closely linked. When the directly operating agents appear to 

 be food or other material taken into the system by the alimen- 

 tary canal or otherwise, a removal of the inducing agent is 

 called for ; and this in many instances may be expedited by 

 the use of mild laxatives. 



When pain, shown by general restlessness or in the employ- 

 ment of local manipulation, is a distinct symptom, this may 

 be alleviated by the employment of heat and moisture to the 

 loins, and the enforcement of perfect rest. 



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